Preoperative to Postoperative: Cannabis Considerations in Surgery

Preoperative to Postoperative: Cannabis Considerations in Surgery

As cannabis use continues to grow, its implications for medical professionals, particularly in surgical settings, have become increasingly significant. Otolaryngologists, who frequently encounter patients using cannabis, must understand the complexities it introduces into patient care. This analysis explores the multifaceted considerations for treating individuals who use cannabis, emphasising the need for comprehensive strategies in surgical settings.

Systemic Effects of Cannabis

Cannabis use has systemic effects that can impact various phases of surgical care. The cannabinoids present in cannabis can influence physiological functions, necessitating careful consideration by healthcare providers. For otolaryngologists, recognising these effects is crucial for optimising patient outcomes.

Preoperative Considerations

One of the primary concerns in treating cannabis users is preoperative counselling. Patients are often advised to taper their cannabis use before surgery to minimise the risk of adverse effects. Increased cannabis use is associated with higher rates of myocardial ischemia and a greater tolerance to standard anaesthesia doses, which can complicate surgical procedures. Therefore, thorough preoperative evaluations are essential to identify and mitigate potential risks associated with cannabis use.

Intraoperative Challenges

During surgery, cannabis can influence anaesthesia management. Patients using cannabis may require higher doses of anaesthetics due to increased tolerance, leading to prolonged sedation and recovery times. These factors necessitate heightened vigilance and potentially adjusted anaesthetic protocols to ensure patient safety.

Postoperative Care and Cannabis

Postoperative care for cannabis users presents additional challenges. While studies offer mixed results, some suggest a correlation between cannabis use and increased incidences of postoperative pain, nausea, and vomiting. Conversely, topical cannabinoids may enhance wound healing, presenting a nuanced picture of cannabis’s role in recovery.

Drug Interactions and Cannabis Use Disorder

Cannabis also poses significant drug-drug interaction concerns, particularly with anticoagulant medications commonly used in postoperative care. These interactions require careful management to avoid complications. Additionally, the prevalence of cannabis use disorder among patients underscores the importance of screening. Short screening tools can help identify patients at risk, providing an opportunity to address potential complications proactively.

Importance for Otolaryngologists

For otolaryngologists, staying informed about the effects of cannabis is increasingly important as its use rises among patients. Comprehensive knowledge of cannabis’s impact on preoperative counselling, anaesthesia, pain management, and drug interactions is critical for optimising patient care. This evolving landscape necessitates continuous education and adaptation to ensure patient safety and effective treatment outcomes.

Source

The JAMA Network

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